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EKG NCLEX REVIEW QUESTIONS AND ANSWERS
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EKG NCLEX REVIEW QUESTIONS AND ANSWERS
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EKG NCLEX REVIEW QUESTIONS AND ANSWERSA 38-year-old female is brought to the Emergency Department with complaints of her
"heart beating out of her chest". She is diaphoretic, tachypneic and her BP is 70/40. The
cardiac monitor shows supraventricular tachycardia. Valsalva maneuvers and three
doses of Adenosine have not been successful. The nurse should immediately:
a.) prepare the patient for synchronized cardioversion.
b.) give Epinephrine 1 mg IV and repeat in 3 minutes.
c.) give Adenosine 6 mg IV per protocol.
d.) perform unilateral carotid massage. - answer- a.) prepare the patient for
synchronized cardioversion.
Prior to discharge from the Emergency Department, the nurse prints a rhythm strip on a
patient and notices that the P wave cannot be detected and the QRS complex is 0.24
seconds. This is a change in the patient's condition. What is the best action for the
nurse to take?
a.) Measure the PR interval.
b.) Prepare the patient for discharge.
c.) Notify the physician of this abnormal strip.
d.) Continue to monitor for abnormalities. - answer- c.) Notify the physician of this
abnormal strip.
Rationale:
c.) is correct because notifying the physician of the abnormal rhythm would be the most
appropriate response. The patient has experienced a rhythm change and requires
further treatment.
a.) is not correct for measuring the PR would not be possible as there is no P wave
present. Since the QRS interval and other parameters given are abnormal, discharging
the patient would not be appropriate at this point.
b.) is not correct as discharging the patient is not appropriate or safe practice.
d.) is not correct because continuing to monitor the patient without any other actions
would be inappropriate as the patient has experienced a change in condition.
A patient is to have synchronized cardioversion for treatment of atrial flutter. He has
received Heparin 500 units subcutaneously. Which of the following interventions should
now be performed?
a.) Assist the MD in intubating the patient to stabilize airway.
b.) Sedate the patient with Versed 2 mg IV push per protocol.
c.) Set the defibrillator in asynchronous mode and charge to 300 joules.
, d.) Steadily increase the voltage until the beats are captured. - answer- b.) Sedate the
patient with Versed 2 mg IV push per protocol.
Rationale:
b.) is correct since cardioversion is very painful, the patient should be sedated prior to
the procedure.
a.) is not correct as intubation is usually not indicated prior to cardioversion.
c.) is not correct as synchronized cardioversion is performed at less voltage than
defibrillation (360 joules). The defibrillator should be set in synchronous mode so the
shock will be delivered on the R wave.
d.) is not correct because steadily increasing the voltage until the beats are captured is
indicative of pacemaker therapy and not synchronized cardioversion.
When a patient has long-term atrial fibrillation, the nurse would expect to include which
drug in the plan of care to minimize the greatest risk that is commonly associated with
atrial fibrillation?
a.) Beta blockers
b.) Digitalis
c.) Anticoagulants
d.) Antiarrhythmics - answer- c.) Anticoagulants
Rationale:
c.) is correct because it reflects the greatest risk or complication of thrombi or emboli
that occurs with long-term atrial fibrillation. Coumadin is often given prophylactically to
prevent stroke, clots, or emboli from developing when hospitalizing a patient with long-
term atrial fibrillation.
The nurse should understand that which of the following treatments for Second Degree
Type II AV Block would be appropriate?
(Select all that apply)
a.) Temporary pacemaker insertion
b.) Close monitoring without intervention
c.) Atropine to increase heart rate if symptomatic
d.) Coronary stent placement to improve blood flow to myocardium
e.) An implantable defibrillator surgically implanted - answer- a.) Temporary pacemaker
insertion
c.) Atropine to increase heart rate if symptomatic
d.) Coronary stent placement to improve blood flow to myocardium
Rationale:
Rationale: a,c, and d are correct. Temporary pacing may be needed and atropine will
temporarily improve heart rate cardiac output until the pacemaker can be inserted.
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